What do you think about the Affordable Care Act?

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In my mind the Affordable Care Act was an instigator if you will, it got a lot of activity moving in the market place, you look around the country right now, there are more alternative payment arrangements, meaning things like accountable care organizations, patients centered medical homes.

Those kinds of arrangements in place in the private sector many multiples of what has been done in the government ACOs because the private sector is good at innovating. It moves with speed. It doesn't have all the bureaucracy in place and so I think the Affordable Care Act actually lit a fire that allowed the private sector to move on and move quickly and bring the parties together.

So I give it a lot of credit for that but I do think the private sector is going to create some of the most innovative and forward thinking arrangements in the marketplace and we absolutely want the government as a partner. Medicare and Medicaid moving to payment models that get created and get driven in the private sector, will create a awful lot of synergy to really transform the entire health market place.